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Electronic cigarette use and smoking initiation among youth: a longitudinal cohort study.
- Source :
-
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne [CMAJ] 2017 Oct 30; Vol. 189 (43), pp. E1328-E1336. - Publication Year :
- 2017
-
Abstract
- Background: The influence of e-cigarette use on smoking initiation is a highly controversial issue, with limited longitudinal data available for examining temporal associations. We examined e-cigarette use and its association with cigarette-smoking initiation at 1-year follow-up within a large cohort of Canadian secondary school students.<br />Methods: We analyzed data from students in grades 9-12 who participated in 2 waves of COMPASS, a cohort study of purposefully sampled secondary schools in Ontario and Alberta, Canada, at baseline (2013/14) and 1-year follow-up (2014/15). We assessed cigarette smoking and e-cigarette use at baseline and follow-up using self-completed surveys. We used generalized linear mixed-effects models to examine correlates of past 30-day e-cigarette use at baseline and smoking initiation between waves within the longitudinal sample.<br />Results: Past 30-day e-cigarette use increased from 2013/14 to 2014/15 (7.2% v. 9.7%, p < 0.001), whereas past 30-day cigarette smoking decreased slightly (11.4% v. 10.8%, p = 0.02). Among the 44 163 students evaluated at baseline, past 30-day e-cigarette use was strongly associated with smoking status and smoking susceptibility. In the longitudinal sample ( n = 19 130), past 30-day use of e-cigarettes at baseline was associated with initiation of smoking a whole cigarette (adjusted odds ratio [OR] 2.12, 95% confidence interval [CI] 1.68-2.66) and with initiation of daily smoking (adjusted OR 1.79, 95% CI 1.41-2.28) at follow-up.<br />Interpretation: E-cigarette use was strongly associated with cigarette smoking behaviour, including smoking initiation at follow-up. The causal nature of this association remains unclear, because common factors underlying the use of both e-cigarettes and conventional cigarettes may also account for the temporal order of initiation.<br />Competing Interests: Competing interests: None declared.<br /> (© 2017 Joule Inc. or its licensors.)
- Subjects :
- Adolescent
Alberta epidemiology
Behavior, Addictive psychology
Cohort Studies
Electronic Nicotine Delivery Systems psychology
Female
Humans
Longitudinal Studies
Male
Ontario epidemiology
Peer Group
Risk Factors
Self Report
Smoking psychology
Tobacco Use Disorder prevention & control
Adolescent Behavior physiology
Behavior, Addictive epidemiology
Electronic Nicotine Delivery Systems statistics & numerical data
Smoking epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1488-2329
- Volume :
- 189
- Issue :
- 43
- Database :
- MEDLINE
- Journal :
- CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
- Publication Type :
- Academic Journal
- Accession number :
- 29084759
- Full Text :
- https://doi.org/10.1503/cmaj.161002